Innovations and criticisms of the organization of mental health care in Italy

After the reform of mental health care system approved in 1978, the structure and organization of Italian mental health care has represented an innovative model of care, shifting from the asylum-based system to the community-based model, with the gradual closure of all mental hospitals. According to the 2023 Mental Health Report, issued every year by the Italian Ministry of Health, more than 700.000 Italian people is suffering from severe mental disorders. The burden on mental health services is highly demanding, with an estimate of more than 9 million of health services provided to patients. With the shift to community-based care, the responsibility for healthcare was moved to regional level. Therefore, a significant heterogeneity and variation in the provision of care has been observed, which is still one of main reasons for concern. In this review we aim to provide an overview on the quality of care in Italy, highlighting the main benefits of the mental healthcare system as well as limitations and pitfalls.